Organization
UP AND BEYOND
Active
Organization
UP AND BEYOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE PITTS (PRESIDENT/CEO)
(480) 550-5113
Entity
Organization
Contact information
Practice address
15425 S 48TH ST STE 100, PHOENIX, AZ 85044-9133
(480) 550-5113
Mailing address
15425 S 48TH ST STE 100, PHOENIX, AZ 85044-9133
(480) 550-5113
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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